Outlook: Obesity

THE PRICE OF OBESITY

The obesity epidemic is dramatically increasing US medical costs, according to a pair of recent studies. In the first, published in the January 2012 edition of the Journal of Health Economics, researchers attempted to calculate the increase in medical costs caused by obesity as opposed to the cost increase correlated with obesity.

Drawing on data from the Medical Expenditure Panel Survey, they analyzed medical spending for more than 20,000 men and women between the ages of 20 and 64 years and found that obesity increased annual medical costs an average of $2741 per person. Extrapolating from these findings, the researchers estimate that the annual national medical care costs for obesity-related illness is more than $200 billion, accounting for over one fifth of all US health expenditures.

The other study, published in the March 2012 edition of the Journal of Occupational and Environmental Medicine, compared the annual incremental medical costs of smoking and obesity for a cohort of more than 30,000 patients, made up of employees of the Mayo Clinic in Rochester, Minnesota, and their dependents.

The results showed that for nonretirees, compared with those with normal body mass index (BMI), those who were obese (BMI between 30 and 35) had on average $1850 in increased annualmedical costs, those categorized as morbidly obese I (BMI between 35 and 40) had on average $3086 in increased annual medical costs, and those categorized as morbidly obese II (BMI over 40) had on average $5467 in increased annual medical costs. Smokers, on the other hand, had on average just $1274 in increased annual medical costs compared with nonsmokers.

NEIGHBORHOODS AND OBESITY

Children and adults who live in neighborhoods that offer increased opportunities for physical activity and access to healthier food are significantly less likely to be obese, according to the results of a study in the May 2012 issue of the American Journal of Preventive Medicine.

For the study, researchers selected neighborhoods in the greater Seattle, Washington, and San Diego, California, areas that rated high or low on 2 measures: physical activity environment (PAE), based on conduciveness to walking and access to high-quality parks, and nutrition environment (NE), based on accessibility of supermarkets and relative scarcity of fast-food outlets. They then recruited families from the selected neighborhoods, measured the height and weight of 1 child and 1 parent from each family, and collected demographic information from each family. (Measurements were taken from 730 families, and 681 children and 679 parents provided demographic information.)

In neighborhoods with high scores on both PAE and NE, 7.7% of children were obese and 23.1% were overweight, compared with 15.9% and 31.7% of children from neighborhoods with low scores on both measures. After adjusting for demographic characteristics, children from neighborhoods with high scores on both measures were 59% less likely to be obese and adults were 43% less likely to be obese than their peers from neighborhoods that scored low on both measures.

MATERNAL OBESITY AND AUTISM

Children born to mothers who are obese during pregnancy are significantly more likely to develop autism or other developmental disabilities, according to the results of a study published in the May 2012 issue of Pediatrics. The study, carried out by researchers at the University of California, Davis, was based on data from the Childhood Autism Risks from Genetics and the Environment study, which enrolled children aged 2 to 5 years between 2003 and 2010.

The study included 517 children with autism, 172 children with other developmental disabilities, and 315 children with normal development. Information on the mothers’ conditions was derived from medical records and interviews.

The results found that children born to obese women were 67% more likely to have autism and 108% more likely to have other developmental disabilities. More than 20% of mothers whose children had autism or other developmental disabilities were obese, compared with 14.3% of mothers whose children developed normally.